[Clinical characteristics and short-term prognosis of 22 cases with SARS-CoV-2 infection associated acute encephalopathy].

Objective: To investigate the clinical features and short-term prognosis of patients with SARS-CoV-2 infection associated acute encephalopathy (AE). Methods: Retrospective cohort study. The clinical data, radiological features and short-term follow-up of 22 cases diagnosed with SARS-CoV-2 infection associated AE in the Department of Neurology, Beijing Children's Hospital from December 2022 to January 2023 were retrospectively analyzed. The patients were divided into cytokine storm group, excitotoxic brain damage group and unclassified encephalopathy group according to the the clinicopathological features and the imaging features. The clinical characteristics of each group were analyzed descriptively. Patients were divided into good prognosis group (≤2 scores) and poor prognosis group (>2 scores) based on the modified Rankin scale (mRS) score of the last follow-up. Fisher exact test or Mann-Whitney U test was used to compare the two groups. Results: A total of 22 cases (12 females, 10 males) were included. The age of onset was 3.3 (1.7, 8.6) years. There were 11 cases (50%) with abnormal medical history, and 4 cases with abnormal family history. All the enrolled patients had fever as the initial clinical symptom, and 21 cases (95%) developed neurological symptoms within 24 hours after fever. The onset of neurological symptoms included convulsions (17 cases) and disturbance of consciousness (5 cases). There were 22 cases of encephalopathy, 20 cases of convulsions, 14 cases of speech disorders, 8 cases of involuntary movements and 3 cases of ataxia during the course of the disease. Clinical classification included 3 cases in the cytokine storm group, all with acute necrotizing encephalopathy (ANE); 9 cases in the excitotoxicity group, 8 cases with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and 1 case with hemiconvulsion-hemiplegia syndrome; and 10 cases of unclassified encephalopathy. Laboratory studies revealed elevated glutathione transaminase in 9 cases, elevated glutamic alanine transaminase in 4 cases, elevated blood glucose in 3 cases, and elevated D-dimer in 3 cases. Serum ferritin was elevated in 3 of 5 cases, serum and cerebrospinal fluid (CSF) neurofilament light chain protein was elevated in 5 of 9 cases, serum cytokines were elevated in 7 of 18 cases, and CSF cytokines were elevated in 7 of 8 cases. Cranial imaging abnormalities were noted in 18 cases, including bilateral symmetric lesions in 3 ANE cases and "bright tree appearance" in 8 AESD cases. All 22 cases received symptomatic treatment and immunotherapy (intravenous immunoglobulin or glucocorticosteroids), and 1 ANE patient received tocilizumab. The follow-up time was 50 (43, 53) d, and 10 patients had a good prognosis and 12 patients had a poor prognosis. No statistically significant differences were found between the two groups in terms of epidemiology, clinical manifestations, biochemical indices, and duration of illness to initiate immunotherapy (all P>0.05). Conclusions: SARS-CoV-2 infection is also a major cause of AE. AESD and ANE are the common AE syndromes. Therefore, it is crucial to identify AE patients with fever, convulsions, and impaired consciousness, and apply aggressive therapy as early as possible.

Ergonomics-oriented operation, maintenance and control of indoor air environment for public buildings

In response to the construction process of Healthy China. it is rather important to create a safe, healthy and energy-efficient indoor environment for public buildings. The public building space is often densely populated, with a large flow of people and many types of air pollution, which presents non-uniform dynamic distribution characteristics. This brings great challenges to the control of indoor air safety, especially during the pandemic period of COVID-19. Excessive ventilation may not only cause large energy waste. but also lead to cross-contamination and even a cluster of infection. In this paper, an operation and maintenance (O&M) control system for indoor air safety is developed based on the core concepts and basic methods of human ergonomics. In this system, one of the important human environmental variables is focused for control, i.e.. indoor air pollution level. Especially after the outbreak of COVID-19. droplets and droplet nuclei from respiration are the most significant air pollution categories required for mitigation. Towards the efficient control of air pollution in large public buildings. it should further take into account the interaction of human, equipment and machines (i.e., ventilation_ air purification and disinfection and intelligent control system) and building environment. Firstly, on the basis of the online monitoring of indoor air pollution concentration and personnel flow, the non-uniform dynamic distribution of indoor pollutants and personnel can be obtained by using the non-uniform and low-dimensional rapid prediction models and computer vision processing. Then, the optimal setting results of ventilation parameters (e.g., ventilation modes, supply air rate. etc.) can be outputted by the environmental control decision system. Finally, based on a combination of monitoring sensors, controllers and actuator hardware equipment (at the location of fans or dampers), the intelligent regulation and control of ventilation system can be realized, aimed at minimizing energy consumption and reducing pollutant concentration and exposure level. Meanwhile, the air purification and disinfection system (especially for the disinfection of virus particles) are operated under the condition of the ventilated environment, which can serve as a powerful auxiliary to the maintenance of indoor air safety. The workflow and effect of the O&M control system are demonstrated by an engineering application case of the front hall in the International Convention and Exhibition Center. The results indicate that the non-uniform and low-dimensional rapid prediction model for pollutant concentration is effective for the ventilation control with the average prediction difference of 11.9%. The implementation of the intelligent ventilation system can reduce the risk of human infection to less than 4%. and its energy-saving ratio for the ventilation can be as high as about 45%. Through optimizing the layout strategies of disinfection devices based on the intelligent ventilation control, the space accessibility of negative oxygen ions can be well accepted, to further increase the removal efficiency of air pollution. The calculated value of space disinfection rate is more than 99%, which can further reduce the risk of infection by 1-2 orders of magnitude. This study can provide an important reference for the promotion and upgrading of O&M control system for indoor air safety.

Ventilation and Low-cost Strategies on Mitigating COVID-19 Infection Disease Transmission in Indoor Environment

During the normalization phase of COVID-19 epidemic, it is gradually reverted to use building space, especially for office. Prevention of airborne pollutant has emerged as a major challenge. Ventilation strategies can mitigate the spread of airborne disease in indoor environment, such as increasing ventilation rate, modifying ventilation mode, etc. The larger ventilation rate can lead to higher energy consumption may not effectively reduce infection risk. The potential of ventilation modes for COVID-19 control should be explored. Furthermore, it is necessary to adopt low-cost strategies, such as physical barrier, to increase the prevention efficiency while combining the ventilation system. This study was to investigate the impact of physical barrier on the spread of particles and infection risk in an office with a sufficient ventilation rate, and then compare different ventilation strategies, including mixing ventilation (MV), zone ventilation (ZV), stratum ventilation (SV) and displacement ventilation (DV), for the optimal one. The simulation model was mainly used in this work and validated by the experiment to show a good agreement with the model prediction. The results showed that (1) the SV showed greater performance in mitigating infection disease spread than MV, ZV and DV, with a minimum infection risk of 13%;(2) a barrier height of at least 60 cm above the desk surface is needed to effectively prevent the transmission of viruses with the risk of infection reduced by about 72%. This work can provide a reference for development of ventilation strategies as well as low-cost prevention interventions in public space oriented the prevention of COVID-19. © The Authors, published by EDP Sciences. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (http://creativecommons.org/licenses/by/4.0/)

A functionalized microwave sensor in a microfluidic platform for rapid detection of SARS-CoV-2

The global COVID-19 pandemic caused by the SARS-CoV-2 has claimed >3.5 million lives and resulted in detrimental social-economic impact. If reliable and rapid test systems were available at home or community level such as drive-by stations, the scope and impact of this tragedy could be largely reduced. Although the vaccine roll out has helped control the pandemic, it is important to develop rapid and accurate testing methods for detection of the SARS-CoV-2 which can be tuned to respond to its variants or similar corona viruses in response to potential outbreaks. In this work, we present a novel method for detection of the SARS-CoV-2 virus based on an antibody functionalized microwave sensor integrated with a microfluidic platform. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

Ergonomics-oriented operation, maintenance and control of indoor air environment for public buildings

In response to the construction process of Healthy China. it is rather important to create a safe, healthy and energy-efficient indoor environment for public buildings. The public building space is often densely populated, with a large flow of people and many types of air pollution, which presents non-uniform dynamic distribution characteristics. This brings great challenges to the control of indoor air safety, especially during the pandemic period of COVID-19. Excessive ventilation may not only cause large energy waste. but also lead to cross-contamination and even a cluster of infection. In this paper, an operation and maintenance (O&M) control system for indoor air safety is developed based on the core concepts and basic methods of human ergonomics. In this system, one of the important human environmental variables is focused for control, i.e.. indoor air pollution level. Especially after the outbreak of COVID-19. droplets and droplet nuclei from respiration are the most significant air pollution categories required for mitigation. Towards the efficient control of air pollution in large public buildings. it should further take into account the interaction of human, equipment and machines (i.e., ventilation_ air purification and disinfection and intelligent control system) and building environment. Firstly, on the basis of the online monitoring of indoor air pollution concentration and personnel flow, the non-uniform dynamic distribution of indoor pollutants and personnel can be obtained by using the non-uniform and low-dimensional rapid prediction models and computer vision processing. Then, the optimal setting results of ventilation parameters (e.g., ventilation modes, supply air rate. etc.) can be outputted by the environmental control decision system. Finally, based on a combination of monitoring sensors, controllers and actuator hardware equipment (at the location of fans or dampers), the intelligent regulation and control of ventilation system can be realized, aimed at minimizing energy consumption and reducing pollutant concentration and exposure level. Meanwhile, the air purification and disinfection system (especially for the disinfection of virus particles) are operated under the condition of the ventilated environment, which can serve as a powerful auxiliary to the maintenance of indoor air safety. The workflow and effect of the O&M control system are demonstrated by an engineering application case of the front hall in the International Convention and Exhibition Center. The results indicate that the non-uniform and low-dimensional rapid prediction model for pollutant concentration is effective for the ventilation control with the average prediction difference of 11.9%. The implementation of the intelligent ventilation system can reduce the risk of human infection to less than 4%. and its energy-saving ratio for the ventilation can be as high as about 45%. Through optimizing the layout strategies of disinfection devices based on the intelligent ventilation control, the space accessibility of negative oxygen ions can be well accepted, to further increase the removal efficiency of air pollution. The calculated value of space disinfection rate is more than 99%, which can further reduce the risk of infection by 1-2 orders of magnitude. This study can provide an important reference for the promotion and upgrading of O&M control system for indoor air safety.

A practical approach for preventing dispersion of infection disease in naturally ventilated room

During the ongoing COVID-19 pandemic period, the airborne transmission of viruses has raised widespread concern as daily activities are resumed in public buildings. It is essential to develop mitigation strategies of infection disease transmission (e.g., increase of ventilation rate) in different scenarios to reduce the infection risk. For classrooms in schools, natural ventilation is generally used to provide outdoor air into rooms. However, the supply air volume depends strongly on the local conditions, e.g., window opening size and outdoor wind speed. In this study, the optimal design of classroom window openings is investigated, based on which low-cost window-integrated fans are then employed to enhance the efficiency of natural ventilation and infection disease control. Taking infected students as pollutant sources, numerical simulations are carried out to predict the pollutant concentration under various scenarios of pollutant sources and window opening modes (with/without fans), and to calculate the infection risk. It is found that by redesigning window openings, the airflow distribution performance index (ADPI) can be increased by 17% with corresponding infection likelihood decreased by 27%. The window integrated fan has a significant effect on improving ventilation performance and prevention of infection disease transmission, leading to an ADPI of 99% and minimum infection probability of 11% for students sitting near the windows. This work can help to develop low-cost and effective mitigating measures of infection disease in classrooms by using hybrid ventilation systems.

The Effect of Feedforward Nursing Quality Management Control on the Sterilization Qualification Rate and Nosocomial Infection Rate

To study the effect of feedforward nursing quality management control in the disinfection supply room in improving the sterilization qualification rate and reducing the nosocomial infection rate under the coronavirus disease 2019 (COVID-19),the feedforward control of nursing quality management in disinfection supply room were implemented when the COVID-19 occurred.Through the summary analysis of nursing quality factors in disinfection supply room and the analysis of the reasons for nursing quality,the feedforward control management scheme in disinfection supply room was established.Moreover,the qualified rate of sterilization and nosocomial infection rate before and after the implementation of feedforward control of nursing quality management in disinfection supply room were counted respectively.Furthermore,the self-designed questionnaire was used to investigate the satisfaction of clinical medical staff on the use of device before and after the implementation of feedforward control of nursing quality management in disinfection supply room.In that case,the effect of feedforward control of nursing quality management in disinfection supply room was evaluated.The qualification rate of device sterilization,the nosocomial infection rate and the satisfaction rate of clinical medical staff were 95.20%,4.20% and 83.00%,respectively,before the implementation of feedforward nursing quality management control in disinfection supply room.While,the qualification rate of device sterilization,the nosocomial infection rate and the satisfaction rate of clinical medical staff were changed to 99.10%,0.40% and 98.00%,respectively,after the implementation of feedforward nursing quality management control in disinfection supply room,which have statistical differences (P<0.05).The application of feedforward nursing quality management control in the disinfection supply room under the COVID-19 could effectively prevent the spread of the virus through non-disposable medical devices in hospitals,increase the qualification rate of device sterilization,reduce the nosocomial infection rate,and improve the satisfaction of clinical care staff. © 2021, Editorial Board of Pharmaceutical Biotechnology. All right reserved.

Location-specific health impacts of climate change require location-specific responses

Left unmitigated, climate change poses a catastrophic risk to human health, demanding an urgent and concerted response from every country. The 2015 Lancet Commission on Health and Climate Change and The Lancet Countdown: Tracking Progress on Health and Climate Change have been initiated to map out the impacts of climate change and the necessary policy responses. To meet these challenges, Tsinghua University, partnering with the University College London and 17 Chinese and international institutions, has prepared the Chinese Lancet Countdown report, which has a national focus and builds on the work of the global Lancet Countdown: Tracking Progress on Health and Climate Change. Drawing on international methodologies and frameworks, this report aims to deepen the understanding of the links between public health and climate change at the national level and track them with 23 indicators. This work is part of the Lancet's Countdown broader efforts to develop regional expertise on this topic, and coincides with the launch of the Lancet Countdown Regional Centre in Asia, based at Tsinghua University. The data and results of this report are presented at the provincial level, where possible, to facilitate targeted response strategies for local decision-makers. Based on the data and findings of the 2020 Chinese Lancet Countdown report, five recommendations are proposed to key stakeholders in health and climate change in China: (1) Enhance inter-departmental cooperation. Climate change is a challenge that demands an integrated response from all sectors, urgently requiring substantial inter-departmental cooperation among health, environment, energy, economic, financial, and education authorities. (2) Strengthen health emergency preparedness. Knowledge and findings on current and future climate-related health threats still lack the required attention and should be fully integrated into the emergency preparedness and response system. (3) Support research and raise awareness. Additional financial support should be allocated to health and climate change research in China to enhance health system adaptation, mitigation measures, and their health benefits. At the same time, media and academia should be fully motivated to raise the public and politicians' awareness of this topic. (4) Increase climate change mitigation. Speeding up the phasing out of coal is necessary to be consistent with China's pledge to be carbon neutral by 2060 and to continue to reduce air pollution. Fossil fuel subsidies must also be phased out. (5) Ensure the recovery from COVID-19 to protect health now and in the future. China's efforts to recover from COVID-19 will shape public health for years to come. Climate change should be a priority in these interventions. © 2021, Science Press. All right reserved.

Early Detection of SARS-CoV-2 Seroconversion in Humans with Aggregation-Induced Near-Infrared Emission Nanoparticle-Labeled Lateral Flow Immunoassay

An outbreak of coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses great threats to human health and the international economy. To reduce large-scale infection and transmission risk of SARS-CoV-2, a simple, rapid, and sensitive serological diagnostic method is urgently needed. Herein, an aggregation-induced emission (AIE) nanoparticle (AIE₈₁₀NP, lambda_em = 810 nm)-labeled lateral flow immunoassay was designed for early detection of immunoglobulin M (IgM) and immunoglobulin G (IgG) against SARS-CoV-2 in clinical serum samples. Using a near-infrared (NIR) AIE nanoparticle as the fluorescent reporter (lambda = 145 nm), the autofluorescence from the nitrocellulose membrane and biosample and the excitation background noise were effectively eliminated. After optimization, the limit of detection of IgM and IgG is 0.236 and 0.125 mug mL^-1, respectively, commensurate with that of the enzyme-linked immunosorbent assay (ELISA) (0.040 and 0.039 mug mL^-1). The sensitivity of the proposed AIE₈₁₀NP-based test strip for detecting IgM and IgG is 78 and 95% (172 serum samples), commensurate with that of ELISA (85 and 95%) and better than that of a commercial colloidal gold nanoparticle (AuNP)-based test strip (41 and 85%). Importantly, the time of detecting IgM or IgG with an AIE₈₁₀NP-based test strip in sequential clinical samples is 1-7 days after symptom onset, which is significantly earlier than that with a AuNP-based test strip (8-15 days). Therefore, the NIR-emissive AIE nanoparticle-labeled lateral flow immunoassay holds great potential for early detection of IgM and IgG in a seroconversion window period.

A multipronged approach to improving genetic counseling in infants with a positive CF newborn screen

Rationale: The CF Foundation and the CDC recommend genetic counseling (GC) for all parents of infants with a positive CF newborn screen (NBS). However, data show that many parents do not receive GC. The goals of this quality improvement (QI) project were (1) increase the rate of GC for parents of NBS+ infants diagnosed with CF or CFTR-related metabolic syndrome (CRMS), (2) utilize an educational video about CF genetics to improve family understanding of the genetic implications of a +CF NBS test, and (3) assess the feasibility of telegenetics for parents who live far from our CF Center. Methods: This QI project was conducted at the CF Center at Riley Hospital for Children, Indianapolis, IN. We performed a fishbone analysis of barriers to GC in our CF clinic and then developed strategies and processes to overcome each of these barriers. These included assigning GC for CF to a specific individual counselor and integrating GC into the clinical processes of the CF Center. We obtained permission from University of Minnesota to adapt an educational video to be shown to families of infants with a +CF NBS coming for sweat testing. We administered a brief knowledge test before and after the video to assess the impact of the video. Finally, we piloted telegenetics with one of our affiliate CF programs that lacked access to GC. Results: In the 3 years preceding our QI project, only 9 out of 46 families with an NBS+ infant with CF or CRMS (20%) received GC. Since starting our project on 9/15/18 to 5/1/20, the GC rate has increased significantly to 76% (32 out of 42 families, P<0.001). Of the 10 families that did not receive GC, 2 declined because they already had GC, 4 were not followed at Riley, and 4 were delayed because of COVID-19. Prior to viewing the educational video, 50% of families scored 100% on the knowledge test, and this increased significantly to 80% of families after the video (P=0.02). We have successfully conducted 9 telegenetics visits. Conclusions: Assigning a specific genetic counselor to families of infants with CF and integrating that person into the clinical processes of the CF Center resulted in increasing GC to these families. An educational video shown during the time of sweat testing can increase families' knowledge of CF genetics. Telegenetics is a promising option for providing GC to families who cannot make in-person visits. A multipronged QI approach can improve access to GC and knowledge about CF genetics for families of CF NBS+ infants.